Hysterostomatomia Sub Partu

HYSTEROSTOMATOMIA SUB PARTU, an obstetric operation; consists of an incision of the external os. H. s. p. is performed when indications exist for accelerated delivery. The cervix must be completely effaced, and the presenting part must have entered the small pelvis. H. s. p. is performed with Scanzoni scissors curved at an angle under the control of two fingers introduced into the vagina, with one finger passing along the inner and the other along the outer surface of the cervix. H. s. p. can also be performed under the control of mirrors. Since H. s. p. is a preparatory operation for the subsequent delivery operation (most often forceps), it is extremely convenient to perform H. s. p. after applying the forceps, of course before beginning traction. Incisions are made to a depth of 1-2 cm in the amount of 2-3-4; it is often sufficient to make two (anterior-right and anterior-left). H. s. p. is most often performed in cases of cervical rigidity when dilation of 3-4 fingers is already present. Furthermore, hysterostomatomia sub partu is performed in cases of scarred closure or adhesion of the os (conglutinatio oris uteri), when, despite extreme thinning, the external os is completely closed. In these cases, it is sufficient to make several incisions, sometimes even just one puncture with a probe or forceps to achieve rapid complete dilation.

Figure 1. Lines of incision in H.: aa-ordinary incision for detachment of the bladder; a b a-the same incision with an additional sagittal; e Bumm's incision; dd-Olshausen's incision.

with a probe or forceps for the purpose of achieving rapid complete dilation.